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Follicular thyroid carcinoma (FTC) presenting as an isolated spinal metastasis with features of compression myelopathy is extremely rare with &lt;10 cases reported in world literature. FTC is the second most common thyroid cancer with an indolent course. It predominantly occurs in females. The most common route of metastasis is through hematogenous routes to lung, liver, bones, etc., Herein we report a case of 47-year-old female presented with lesion involving sacral vertebrae and biopsy showing metastatic follicular carcinoma with morphology and immunohistochemistry of thyroid gland. The present case highlights the rarity of FTC to present as upfront solitary vertebral metastases with history of prior hemithyroidectomy. All the cases of spinal mass should be evaluated thoroughly to exclude any metastatic deposits.

A rare case of sacral metastasis of unknown follicular thyroid carcinoma radiologically mimicking as chordoma